Dentists are in a unique position to intervene with patients who use tobacco products. Research demonstrates their effectiveness in treating patients with tobacco dependence; however, as with other healthcare professionals, few dentists provide tobacco cessation services. In recent years, there has been an increase in the number of dental schools that recommend students discuss tobacco cessation with their patients, yet implementation of tobacco education in the curriculum is non-systematic and inconsistent. Rather than focusing effort on the development, implementation and assessment of a pre-doctoral tobacco cessation curriculum, the aim of this project is to collaborate with the developers of Rx for Change, a comprehensive tobacco cessation counseling curriculum for health professions. This curriculum is part of the required training at all California schools of pharmacy and at the University of California, San Francisco, School of Medicine, and recently received funding from the NCI for dissemination to all schools of pharmacy in the US. The curriculum modules will be adapted as necessary for use in dental education and integrated into appropriate courses throughout the 4-year dental curriculum at Baylor College of Dentistry (BCD). Full integration of the Rx for Change core curriculum will occur over a period of 3 years. Assessment over the 3-year integration will provide a baseline and progressive measurement of student performance. Changes in dental practice-based tobacco cessation activities of graduates will be assessed annually throughout the 5-year project, compared across time within cohorts and across the continuum of cohorts from those receiving no tobacco cessation curriculum to those who receive the fully integrated curriculum. AIM 1: Modify and integrate the Rx for Change curriculum into didactic and clinical instruction throughout pre-doctoral dental education at BCD; AIM 2: Evaluate changes in pre-doctoral dental students' knowledge, attitudes and beliefs across 4 years of schooling as a function of the extent of curriculum implementation; AIM 3: Assess the tobacco cessation counseling competency of 3rd year pre-doctoral dental students using an Objective Structured Clinical Examination; AIM 4: Estimate the impact of the training program on graduates' incorporation of tobacco cessation counseling into clinical practice; AIM 5: Quantify changes and national trends in the extent and quality of tobacco cessation training in US dental schools. [unreadable] [unreadable]